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What Is the Bipolar Spectrum?

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The Bipolar Spectrum: Bipolar I - IV? continued...

The concept of a bipolar spectrum may include additional subtypes of bipolar disorder that were proposed in the 1980s. Those subtypes include:

  • Bipolar IV, identified by manic or hypomanic episodes that occur only after taking antidepressantmedications
  • Bipolar V, which refers to patients who have a family history of bipolar disorder but only have symptoms of major depression themselves

The symptoms described by these last two subtypes have long been known to exist. But they have not been rigorously studied enough to warrant their being made distinct diagnostic categories.

Possible Bipolar Spectrum Conditions

The idea of a broader "bipolar spectrum" involves the idea that people with certain other mental conditions may be in the bipolar spectrum. Mental or behavioral conditions that share some common features with bipolar disorder, and are therefore sometimes included within a possible bipolar spectrum,  include:

Researchers are still trying to determine when and how conditions such as these may overlap with bipolar disorder in terms of symptoms, underlying biology, and possible treatment implications. 

Overlapping Symptoms of Bipolar Spectrum Conditions and Bipolar Disorder

A number of mental conditions other than bipolar disorder share symptoms that overlap across disorders. For example, many people with borderline personality disorder experience depression or substance use disorders experience depression along with severe mood swings and problems with impulse control.  People with ADHD and bipolar disorder may similarly experience distractibility and problems with attention. 

Although these disorders do not meet the diagnostic criteria for bipolar illness, some psychiatrists believe they have something important in common with people with bipolar disorder.

Symptoms that may overlap between bipolar spectrum conditions and bipolar disorder include:

  • Depression with very sudden or frequent mood swings (seen in many mental conditions)
  • Prolonged irritability (which may be more common in mania than depression)
  • Impulsivity (common during manic episodes)
  • Euphoria and high energy (which can sometimes occur in substance abusers even when they are not intoxicated or "high" from the effects of drugs)

Because the cause of bipolar disorder isn't known, it's difficult for experts to know the real overlap between bipolar disorder and a possible broader bipolar spectrum.

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